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Measuring Maternal Mortality

black pregnant woman getting doctor checkup
Authors
  • Laurie Zephyrin, M.D.
    Laurie Zephyrin

    Senior Vice President, Advancing Health Equity, The Commonwealth Fund

  • Eugene Declercq
    Eugene Declercq

    Professor, Community Health Sciences, Boston University School of Public Health

Authors
  • Laurie Zephyrin, M.D.
    Laurie Zephyrin

    Senior Vice President, Advancing Health Equity, The Commonwealth Fund

  • Eugene Declercq
    Eugene Declercq

    Professor, Community Health Sciences, Boston University School of Public Health

Toplines
  • New U.S. maternal mortality data will allow us to compare rates between states and with other countries and to track the results of health care interventions

  • Rates of death during or immediately after pregnancy are higher in the U.S. than in other developed nations, and there are stark disparities along racial and ethnic lines

Last week, for the first time since 2007, the National Center for Health Statistics (NCHS) reported new data on maternal mortality in the United States. As a result, we now also have a much more accurate picture of what is happening in the U.S. In previous years, not all states collected the same data in the same way. Now, we can compare rates between states and even globally.

The new reports confirm troubling findings:

  • Maternal mortality rates in the U.S. are unacceptably high (17.4 deaths per 100,000 births) and exceed those in other developed countries. Global maternal mortality rates are declining in most countries but are unchanged in the U.S. and even increasing for some groups.
  • Stark and unacceptable racial and ethnic disparities persist: 37.1 deaths for non-Hispanic blacks compared to 14.7 for non-Hispanic whites and 11.8 for Hispanic women.

The new data confirm that there is in fact a maternity crisis in the U.S. and that this disproportionately impacts non-Hispanic black women. Notably, a separate report based on Centers for Disease Control and Prevention data also found maternal death rates among Native American mothers more than double those of whites.

Where do we go from here? We use these new data to track these disparate outcomes and compare the results of interventions. We also can compare ourselves to peer countries and investigate best practices and investments in health. Maternal mortality measurements are used globally as a test of a society’s health care system and commitment to equity. Having an accurate maternal mortality measure is as important as knowing a country’s GDP.

Finally, we need to redesign maternity care. Policymakers at the state and federal level should develop payment, policy, and delivery system interventions that will protect pregnant people and provide the care and resources necessary for them and their families to thrive. This includes, for example, ensuring that women of childbearing age have health insurance and access to health care. Extending Medicaid coverage from 60 days after childbirth to one year will improve maternal mortality rates. Moreover, policies should address racial and ethnic disparities in maternity outcomes.

No woman in a country with our resources and track record of innovation should die because of pregnancy. We have made great strides in improving clinical care around childbirth. These have been reflected in decreasing rates of maternal deaths for specific causes such as hemorrhage, eclampsia, and embolisms. We can continue to make progress on maternal deaths — these new data will be vital in tracking that progress.

Publication Details

Date

Citation

Laurie Zephyrin and Eugene Declercq, “Measuring Maternal Mortality,” To the Point (blog), Commonwealth Fund, Feb. 6, 2020. https://doi.org/10.26099/c14w-nq52